This Year's Top Eye Stories: Detergent Burns, Solar Retinopathy, and More

The most viewed articles from JAMA Ophthalmology in 2017

Ocular burns from detergent pods, retinopathy after the solar eclipse, undiagnosed macular degeneration, and mortality in older women who had cataract surgery led the list of JAMA Ophthalmology's most popular articles in 2017.

These stories were in the top 5% of resource outputs scored by Altmetric, a company that measures how much attention scientific and scholarly articles receive by tracking social network mentions, mainstream media coverage, and other references.

Detergent Pods Lead to Surge in Eye Burns

Nearly 500 small children suffered vision-threatening ocular burns from laundry detergent pods in 2015 -- a substantial jump from only 12 such incidents in 2012, reported R. Sterling Haring, DO, MPH, of Johns Hopkins University and colleagues in a research letter.

These brightly-colored, dissolvable pouches contain a small amount of concentrated laundry detergent. Injuries occurred when children handled the pods and contents squirted into their eyes, or when children touched their eyes after detergent leaked onto their hands.

As a proportion of all chemical ocular injuries among children 3 to 4 years old, burns from laundry soap pods jumped from less than 1% in 2012 to 26% in 2015. All patients were treated and released from emergency departments.

"In addition to proper storage and use of these devices, prevention strategies might include redesigning packaging to reduce the attractiveness of these products to young children and improving their strength and durability," the authors concluded.

Solar Eclipse Damages Woman's Retina

Acute solar retinopathy can lead to localized foveal cone photoreceptor injury, according to a case report of a woman treated at the New York Eye and Ear Infirmary of Mount Sinai.

During the eclipse, a young woman viewed the solar rim several times for approximately 6 seconds without protective glasses, then again for about 15 to 20 seconds with a pair of eclipse glasses.

Four hours later, she noted blurred vision, metamorphopsia, and color distortion which were worse in her left eye, according to Avnish Deobhakta, MD, and colleagues. The patient also reported seeing a central black spot in her left eye.

Microperimetry showed paracentral decreased retinal sensitivity in the left eye with a central absolute scotoma. Six weeks after the eclipse, the patient's central scotoma in the left eye persisted.

"When severe, solar retinopathy can cause an absolute scotoma," the authors wrote. "Young adults may be especially vulnerable and need to be better informed of the risks of directly viewing the sun without protective eyewear."

A total of 30% of these eyes, all in patients 60 and older, had AMD with large drusen that would have been treatable with nutritional supplements had it been diagnosed, according to an investigation by David C. Neely, MD, of the University of Alabama at Birmingham, and colleagues.

Undiagnosed AMD was associated with older patient age (OR 1.06), male sex (age-adjusted OR 1.39), and less than a high school education (age-adjusted OR 2.40). The prevalence of undiagnosed AMD was not different for ophthalmologists and optometrists.

AMD is a significant public health concern and this study "suggests that AMD is sometimes not diagnosed in older adults receiving a dilated comprehensive eye examination in primary eye care despite its presence," the authors wrote. Improved detection strategies may be needed in primary eye care as more effective AMD treatments become available, they added.

Cataract Surgery Tied to Longer Life

Cataract surgery is associated with lower risk for total and cause-specific mortality in older women, for unclear reasons.

An analysis of 74,044 female cataract patients whose average age was 70.5 found that cataract surgery was associated with lower all-cause mortality (adjusted HR 0.40), Anne L. Coleman, MD, PhD, of the University of California Los Angeles and co-investigators reported.

This analysis, which linked nationwide data from the Women's Health Initiative with Medicare claims, was the first to examine associations between cataract surgery and cause-specific mortality.

"The cataract surgery group demonstrated a noticeably lower mortality rate compared to the cataract diagnosis group, despite an overall sicker systemic disease profile," the researchers observed. "We suspect that these differences cannot be explained by cataract surgery alone and that patients with cataract who do and do not receive surgery have inherent demographic, socioeconomic, and systemic differences that must be further explored in future studies."

No potential conflicts of interest were reported by the researchers in these studies.

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